Forty-slice MDCT enteroclysis: evaluation after oral administration of isotonic solution in Crohn’s disease

Abstract

MDCT enteroclysis after oral hyperhydration with isotonic solution showed a high level of accuracy in detecting small bowel changes in patients with Crohn's disease. It can be considered a safe and effective alternative to conventional radiography and small-bowel spiral computed tomography enema, especially in patients who refuse nasojejunal intubation.

CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

“…PEG was chosen for its no osmotic effects and for its pleasant, sweet taste, which makes it more acceptable to patients. To minimise potential artefacts due to peristaltic bowel movement, to obtain homogeneous small bowel distension and to reduce abdominal discomfort, all patients underwent intravenous (IV) administration of an anticholinergic compound, 20 mg of N-butyl-joscine bromide (Buscopan, Boehringer Ingelheim, Reggello, Florence, Italy) 10 min before the CT scan [18]. All patients were studied with a 64-slice MDCT scanner (Brilliance 64, Philips Medical System, Cleveland, Ohio, USA) using the following scan parameters: collimation, 64 9 0.625 mm; gantry rotation time, 420 ms; slice thickness, 1.5 mm; slice increment, 0.7 mm, 140 kV, 250 mAs.…”

“…The examinations were performed 50 s after the IV administration of 1.5 mL/ kg of iodinated nonionic contrast medium (iodixanol, Visipaque 320, GE Healthcare S.r.l. Milan, Italy) at a mean flow rate of 3 mL/s [18]. The CTE scan was performed with the patient in the supine position, and the scanning volume was acquired from the diaphragm to the perineum during a single breath-hold.…”

Conventional Radiology in the Evaluation of the Small Bowel

“…The surgical physical examination has been considered the "gold standard" (sensitivity 99.8 %) for the identification of perianal fistulas in CD for years [7]. Actually, MRI has an increasingly important role in the evaluation of disease activity in CD and of complicated CD and is actually considered the gold standard and recommended during the initial diagnosis of perianal CD according to the ECCO guidelines; moreover, compared to endoanal ultrasound it is comparable for the evaluation of perianal fistulas and proved to be superior for discriminating between simple and complex disease compared to clinical assessment and anal endosonography [10,[30][31][32][33][34][35].…”

The role of nasoenteric intubation in the MR study of patients with Crohn’s disease: our experience and literature review

“…collabite, e quindi una valutazione dello spessore di parete, intesa come presenza o assenza di malattia non risulta adeguata [22,25]. Nel campione in esame la non significatività numerica dei pazienti con localizzazione al digiuno e all'ileo prossimale, non consente di ottenere dati statisticamente rilevanti, sebbene sia da sottolineare come nel solo paziente in cui era presente un focolaio digiunale e sottoposto ad MR-os la lesione sia stata misconosciuta all'esame di RM, così come sono state misconosciute alla MR-os le due lesioni poste all'ileo prossimale e note all'enteroclisi, mentre è stata confermata la lesione ileale prossimale, riscontrata all'enteroclisi, nel paziente sottoposto ad MR-e. Sono auspicabili maggiori contributi in letteratura di casistiche su pazienti con localizzazione digiunale ed ileale prossimale.…”

“…La possibilità di seguire la distensione intestinale, con sequenze idrografiche real-time, consente all'operatore di identificare già durante le prime fasi dell'esame il tratto poid appearance [25]. These elements when combined give the mucosa the cobble-stone sign that is well known in barium enteroclysis.…”